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Can We Predict Who Will Crave Alcohol?

In the context of substance use, craving means a strong urge to drink more alcohol or take more drugs or medications. People affected by substance cravings are significantly at-risk for developing substance use disorder. In a study published in January 2014 in the journal Addictive Behaviors, researchers from three U.S. institutions sought to determine whether three specific factors can predict a drinker’s chances of developing alcohol cravings. These factors are gender, the amount of alcohol a person has already consumed in a drinking session and a person’s score on a screening procedure called the Alcohol Use Disorders Identification Test (AUDIT).

Craving Basics

Alcohol craving can be viewed from two basic perspectives. To the affected individual, a craving is a detectable urge or desire to consume more alcohol. Although the specific feeling associated with this urge or desire can vary, it ultimately produces a strong incentive to keep drinking. Doctors can also use physical testing to detect objective signs of alcohol craving, including such things as increases in sweat production and alteration of normal blood pressure levels and heartbeat rates. Cravings are often linked to cues that consciously or unconsciously prime a person for drinking. Internally, potential examples of these cues include negative or “down” emotional states, positive or “up” emotional states, headaches or other physical changes in brain or body function, and complex patterns of thought that defy easy description. Potential examples of external cues for alcohol craving include being in a place where drinking usually occurs, interacting with alcohol-drinking friends or even passing through a time of day when drinking often or typically occurs.

AUDIT Basics

Experts at the World Health Organization, the public health branch of the United Nations, developed the Alcohol Use Disorders Identification Test roughly 30 years ago. The test contains 10 questions designed to elicit key information regarding a person’s habitual drinking behaviors. These questions are all answered on a sliding scale that indicates level of involvement in a given behavior. They address issues such as frequency of alcohol consumption, daily frequency of alcohol consumption, frequency of participation in heavy drinking, the relative ability to control alcohol intake, a drinking-related failure to meet obligations or responsibilities, frequency of regret regarding one’s drinking or related behaviors, exposure to alcohol-related injury and receipt of alcohol intervention efforts from an acquaintance or medical professional. The maximum possible AUDIT score is 40; people who score eight or above likely have a significantly dysfunctional relationship to alcohol consumption.

Predicting Cravings

In the study published in Addictive Behaviors, researchers from the Center for Alcohol and Addiction Studies, Developmental Exposure Alcohol Research Center and the State University of New York, Binghamton, used an examination of 1,320 adult drinkers to determine if it’s possible to predict a person’s chances of developing alcohol cravings. Rather than being studied in a laboratory setting, all of these participants were studied in any every day bar-like setting. In addition to recording the gender and AUDIT score of each participant, the researchers recorded each participant’s level of involvement in regular drinking and number of drinks consumed in a single drinking session.

All of the study members were asked to rank their level of alcohol craving from zero to 10. The researchers then investigated whether gender, AUDIT scores or current level of intoxication could help predict a given individual’s craving level. After completing a complex statistical analysis, they concluded that the factors for predicting alcohol craving differ between men and women. In men, the only true predicting factor for craving is a high AUDIT score. The results for women are more complicated. Both AUDIT scores and level of current alcohol consumption play a role in determining which women will experience alcohol cravings. In addition, the level of craving rises along with a woman’ AUDIT score, as well as with the number of drinks a woman consumes in a given drinking session.

Significance and Considerations

The authors of the study published in Addictive Behaviors believe their attempts to predict alcohol cravings in a naturalistic setting rather than a laboratory setting are unique. Based on their findings, they conclude that women with a history of dangerous drinking behaviors who consume multiple drinks in one sitting have unusually strong chances of developing alcohol cravings and subsequently failing to control their alcohol intake. They believe that public health officials should take this information into account when planning and carrying out their anti-drinking and drinking intervention programs.

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